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LEVEL I SCREENING
FOR MENTAL ILLNESS, INTELLECTUAL DISABILITY, OR RELATED CONDITIONS
This form, or the DMAS95 for Medicaid members, must be completed for ALL individuals seeking a Nursing Facility
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How to fill out level i screening for
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To fill out Level I screening form, follow these steps:
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Gather all the necessary information such as personal details, contact information, and relevant background information.
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Start by providing your full name, date of birth, and gender in the respective fields.
04
Fill in your current address and contact details including phone number and email address.
05
Provide information about your education and employment history, including the names of institutions and companies, dates attended or worked, and positions held.
06
Answer all the screening questions honestly and accurately. These questions may pertain to criminal history, drug use, mental health, or any other relevant factors.
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If required, provide additional documentation or references to support your screening process.
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Review all the information filled out for accuracy and completeness before submitting the form.
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Submit the completed Level I screening form through the designated method or platform specified by the organization or authority.
Who needs level i screening for?
01
Level I screening is required for individuals who are seeking employment, volunteering, or participating in programs where a basic background check is necessary.
02
It is also necessary for individuals who are applying for licenses or certifications in certain professions that require a minimum level of screening.
03
Organizations, companies, or authorities may also require Level I screening for their employees or members to ensure safety and security.
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What is level i screening for?
Level I screening is an initial assessment process used to determine if an individual meets the criteria for further evaluation or specific services.
Who is required to file level i screening for?
Individuals or organizations that provide certain services or support to individuals in need, such as healthcare providers, educational institutions, or social service agencies, are typically required to file Level I screening.
How to fill out level i screening for?
To fill out Level I screening, collect necessary personal information, answer specific questions related to the individual's background and needs, and submit the completed form to the appropriate agency.
What is the purpose of level i screening for?
The purpose of Level I screening is to quickly assess an individual's eligibility for services and to identify any immediate needs that require further assessment.
What information must be reported on level i screening for?
The information that must be reported on Level I screening includes personal identification details, demographic information, health status, previous service use, and specific needs or concerns.
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